340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA PHARMACY 1031
RWII79601 Dignity Health Management Center, Inc.
Print
Covered Entity Details
Entity Name
Dignity Health Management Center, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII79601
Entity Address
402 Butternut St.
Abilene, TX 79602
Grant Number
X07HA00054
Participating Start Date
4/28/2022
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1031
Pharmacy Address
PHARMBLUE HOLDINGS LLC D/B/A AVITA PHARM
1495 N 7TH ST STE B
BEAUMONT, TX 77702-1345
Pharmacy Comments
Contract Details
Approval Date
4/28/2022
Contract Begin Date
4/28/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Wagstaff, Executive Director
(917) 570-8015
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/28/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session